title: Orbital mass as manifestation of Wegener's granulomatosis: an ophthalmologic diagnostic approach.
abstract: OBJECTIVE
  Orbital manifestation of Wegener's granulomatosis is diverse and diagnosis is often difficult. This study aims to improve the diagnostic strategy in orbital Wegener.
  
  
  METHODS
  A review of the diagnostic process in patients in whom a diagnosis of orbital WG was considered.
  
  
  RESULTS
  Thirty-three patients were analysed, consisting of 15 patients with orbital WG, 11 with idiopathic orbital inflammation, 6 with orbital sarcoidosis and one with aspergillosis. Diagnostic findings indicating orbital WG were ear/nose/throat involvement, multiple organ system involvement, a positive ANCA, and on histology vasculitis, whereas granulomatous inflammation without signs of vasculitis was more indicative of another orbital disease.
  
  
  CONCLUSIONS
  The diagnostic process of orbital WG should include CT scanning of the orbit and sinuses, ANCA blood testing, consultation of a rheumatologist, an ophthalmologist, and an ear-nose-throat specialist, and biopsy of an easily accessible, active inflammatory lesion.
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, the Netherlands. w.r.bijlsma@umcutrecht.nl
authors.forename: Ward R
authors.initials: WR
authors.lastname: Bijlsma
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Hené
authors.forename: Maarten P
authors.initials: MP
authors.lastname: Mourits
authors.forename: Rachel
authors.initials: R
authors.lastname: Kalmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002648:Child; D003937:Diagnosis, Differential; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000473:pathology; D009426:Netherlands; D009915:Orbit / Q000473:pathology*; D009916:Orbital Diseases / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D010256:Paranasal Sinuses / Q000473:pathology; D011237:Predictive Value of Tests; D012017:Referral and Consultation; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D015415:Biomarkers